A lawsuit claims UT Tyler Health Science Center is trying to pull the veil of governmental immunity over doctors who do all of their work for a for-profit, private equity-backed health care system.
Michelle Simington shows a photo of her father-in-law Mike Simington before he passed away at 71. By the time he learned he had prostate cancer, it had spread to his bones.Michael Simington wasn’t one to see a doctor. But when the 67-year-old retired welder started having trouble urinating, he knew something was wrong.
That’s when Simington fell through a trapdoor in Texas’ medical malpractice system and found himself facing an unexpected adversary: the University of Texas System. In March 2023, Simington recorded a statement from his bed in the corner of his son’s living room. The frail, sunken man on camera is virtually unrecognizable from the sturdy, foul-mouthed fisherman featured in photographs around the house. He was in unrelenting, teeth-chattering pain as the cancer essentially starved him to death.
UT Health East Texas was created in partnership with UT Tyler Health Science Center, the graduate medical education center in the region. But most of the funding for this acquisition came from the university’s for-profit partner: Ardent Health Services. Ardent invested almost $350 million to buy the ETMC properties and promised $125 million in system improvements.
“These partnerships with academic health centers and nonprofits are relatively new, and they’re playing under the radar,” said Eileen O’Grady, healthcare director at Private Equity Stakeholder Project, an industry watchdog. “It allows a private equity firm to penetrate a market that has historically not been available to PE, and to do so with, I would argue, less financial risk.”In East Texas, Ardent was welcomed in with open arms, heralded as a savior for a health care system on the brink.
“I didn’t realize until I looked into it,” Martin said. “But the way they’ve set up , there’s no way to hold the doctors working here accountable.”Since it launched, UT Health East Texas has expanded far beyond ETMC’s original footprint. Originally, there were 52 physician clinics under its name. Today, it has more than 90.assured patients they could see the “same providers in the same locations with the same telephone numbers.
“There is a growth of the program throughout East Texas,” Hill said. “And so I think all of this has been preparatory and planned. So having the growth of university physicians throughout makes sense.” After the biopsy, Simington said he never heard from Garcia. His medical records show a follow-up appointment was scheduled for two weeks later, but Simington said he was never told about this, and there wasn’t a “no show” noted in his file, according to the report from the UCLA expert.
When an oncologist did a bone scan, “his whole body just lit up,” Rodney said. “It was in his hips, his knees, ankles, back, neck, shoulders. It metastasized into the bones.” “Normally, we wouldn’t take a misdiagnosis or delayed diagnosis, because they get to them timely enough to where it didn’t really change the outcome,” Martin said. “But here, 18 months, with no treatment and not telling him and allowing it to spread throughout his body in such an aggressive manner, it’s inexcusable.”If Garcia is employed by UT Health East Texas, a private, for-profit company, Simington could have sued under the typical medical malpractice statute.
This is the two-tiered system of medical malpractice liability in Texas: Doctors employed by private health care systems can be held liable for malpractice; doctors employed by government medical facilities, like county hospitals and academic health centers, generally cannot. Texas courts have tended to rule that doctors can carry their immunity with them, even when practicing at a non-governmental medical facility, as long as the government agency still retains the “right to control” the doctor’s work.
Further details about the partnership and terms of Garcia’s employment are contained in nearly 900 pages of documents filed with the court under a protective order. Martin twice had to ask the judge to intervene to get UT Health East Texas to hand over records he was due as part of the standard discovery process. He has, unsuccessfully, petitioned the court to unseal the records.
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